EDITORIAL

ARE WOMEN MORE LIKELY TO BE BLIND OR VISUALLY IMPAIRED THAN MEN?

¿SON LAS MUJERES MÁS PROPENSAS QUE LOS HOMBRES
A MANIFESTAR DISFUNCIONES VISUALES Y CEGUERA?

ILENE K. GIPSON, PhD¹, VIRGINIA M. TURNER, PhD²

In 2001, an analysis of 70 population-based blindness prevalence studies demonstrated that two-thirds of all blind and visually impaired persons throughout the world are women (1). In 2004, an analysis of data from eight blindness and low vision prevalence studies did not find increased rates of blindness in women, per se, but the age-adjusted prevalence of low vision was significantly higher for women among white persons while it did not differ significantly by gender among black or Hispanic persons (2). Yet another study published the same year suggested that visual impairment increases with age and is greater in Latino women than in Latino men (3). Membership data from Organización Nacional de Ciegos Españoles (ONCE) suggested no gender difference (4).

Gender differences in rates of blindness and visual impairment, when noted, can be accounted for by:

Female longevity.— Because women live longer than men, they experience more blindness due to age-related diseases. Two of the more important of these are cataract and (the much-less-treatable) age-related macular degeneration (AMD).

Intrinsic factors.— A number of eye diseases are intrinsically more prevalent in women. For example, dry eye syndrome has been shown to be two-to-three times more prevalent in women than in men, at any given age (5). In addition, women are at higher risk of several autoimmune (rheumatological) diseases, which often have important ocular manifestations. Some of the most common of these diseases include systemic lupus erythematosus, rheumatoid arthritis, multiple sclerosis, and Sjögren's syndrome.

Access to health care.— Greater prevalence of blindness and visual impairment in women may be associated with social or economic factors limiting access to care. Frequency and/or quality of health care sought by, or available to, women may be different for men.

Behavioral and environmental factors that can increase the risk of developing eye problems —while not intrinsic to gender— include: poor nutrition, obesity (a risk factor for diabetes/diabetic retinopathy) and, especially, smoking. Smoking is a proven risk factor for the eye diseases cataract and AMD, as well as being a proven risk factor for cardiac disease, cancer and stroke.

Nonetheless, either by virtue of absolute numbers or greater risk - women need to know about preventing blindness and visual impairment in themselves, their families and communities. To this end, The Women's Eye Health Task Force (WEHTF) was formed to actively address the need for better understanding of gender and blindness issues. The WEHTF is committed to reducing the burden of blindness and visual impairment through advocacy for women's eye health issues; supporting public education concerning prevention and treatment of eye disease; building awareness within professional organizations of women's eye health issues; and ensuring that eye research priorities reflect the importance of women's eye health.

The WEHTF Executive Committee and Advisory Board include ophthalmologists, epidemiologists and other interested scientists from many universities and organizations throughout the world. The WEHTF is based at The Schepens Eye Research Institute (SERI) in Boston, Massachusetts, USA and can be reached through its website at http://www.womenseyehealth.org.

Blindness was a theme that played an important role in the Spanish painter Pablo Picasso's (1881-1973) first distinctive style, known as his Blue Period (6). He created three portraits depicting blindness: La Celestine (a woman); The Old Guitarist (an old man); and The Blind Man's Meal (a man at table for a meal). These days, painters interested in blindness as a theme, might find more women than men as models for the canvas.

ACKNOWLEDGMENTS

The WEHTF is supported by grants from The Lions Club International Foundation and The Lions Eye Health Program, The Schepens Eye Research Institute, and Healthy Vision 2010.

¹ Chair, Women's Eye Health Task Force (WEHTF), Senior Scientist, The Schepens Eye Research Institute. Professor of Ophthalmology, Department of Ophthalmology. Harvard Medical School, Boston, MA, USA.
E-mail: gipson@vision.eri.harvard.edu
² Program Coordinator, WEHTF, based at Schepens Eye Research Institute, Boston, MA, USA.
E-mail: vturner@vision.eri.harvard.edu

REFERENCES

1. Abou-Gareeb I, Lewallen S, Bassett K, Courtright P. Gender and blindness: a meta-analysis of population-based prevalence surveys. Ophthalmic Epidemiol 2001; 8: 39-56.

2. Congdon N, O'Colmain B, Klaver CC, Klein R, Munoz B, Friedman DS, Et al. Causes and prevalence of visual impairment among adults in the United States. Arch Ophthalmol 2004; 122: 477-485.

3. Varma R, Ying-Lai M, Klein R, Azen SP, Los Angeles Latino Eye Study Group. Prevalence and risk indicators of visual impairment and blindness in Latinos: the Los Angeles Latino Eye Study. Ophthalmology 2004; 111: 1132-1140.

4. ONCE Website: HTTP://www.once.es. Find «Nuevos contenidos» bottom of web page. Choose «La afilicion a la ONCE ronda las 66.000 personas deficientes visuales ultimas estadisticas.» (Fuente: Registro de afiliados a la ONCE. Diciembre 2004).

5. Schaumberg DA, Gardiner M, Schein OD. Epidemiology of major cornea and external diseases. In: Foster CS, Azar DT. Smolin and Thofts' The Cornea, Scientific Foundations and Clinical Practice. Philadelphia PA: Lippincott Williams & Wilkins; 2004.

6. Ravin JG, Perkins J. Representations of blindness in Picasso's Blue Period. Arch Ophthalmol 2004; 122; 636-639.